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Effect of Anti-TNF Agents on Postoperative Outcomes in Inflammatory Bowel Disease Patients: a Single Institution Experience

  • 2016 SSAT Poster Presentation
  • Published:
Journal of Gastrointestinal Surgery Aims and scope

Abstract

Background

Anti-tumor necrosis factor (TNF) agents have been an integral part in the treatment of inflammatory bowel disease. However, a subset of inflammatory bowel disease patients ultimately requires surgery and up to 30 % of them have undergone treatment with anti-TNF agents. Studies assessing the effect of anti-TNF agents on postoperative outcomes have been inconsistent. The aim of this study is to assess postoperative morbidity in inflammatory bowel disease patients who underwent surgery with anti-TNF therapy prior to surgery.

Methods

This is a retrospective review of 282 patients with inflammatory bowel disease undergoing intestinal surgery between 2013 and 2015 at the Mount Sinai Hospital. Patients were divided into two groups based on treatment with anti-TNF agents (infliximab, adalimumab, certolizumab) within 8 weeks of surgery. Thirty-day postoperative outcomes were recorded. Univariate and multivariate statistical analyses were carried out.

Results

Seventy-three patients were treated with anti-TNF therapy within 8 weeks of surgery while 209 patients did not have exposure. Thirty-day anastomotic leak, intra-abdominal abscess, wound infection, extra-abdominal infection, readmission, and mortality rates were not significantly different between the two groups.

Conclusions

The use of anti-TNF medications in inflammatory bowel disease patients within 2 months of intestinal surgery is not associated with an increased risk of 30-day postoperative complications.

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Abbreviations

IBD:

Inflammatory bowel disease

Anti-TNF:

Anti-tumor necrosis factor

CD:

Crohn’s disease

UC:

Ulcerative colitis

ASA:

American Society of Anesthesia

BMI:

Body mass index

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Authors and Affiliations

  1. Department of Surgery, Division of General Surgery, Icahn School of Medicine at Mount Sinai, 1 Gustave L. Levy Place, Box 1041, New York, NY, 10029, USA

    Chaya Shwaartz, Adam C. Fields, Maximiliano Sobrero, Brian D. Cohen & Celia M. Divino

Authors
  1. Chaya Shwaartz
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  2. Adam C. Fields
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  3. Maximiliano Sobrero
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  4. Brian D. Cohen
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  5. Celia M. Divino
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Corresponding author

Correspondence to Celia M. Divino.

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All authors contributed significantly to the study (including the design of the work, analysis, and interpretation of data), agreed to the work in its final form, revised the work and approved the final version, and agreed to be accountable for all aspects of the work.

There was no financial support to this work.

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Shwaartz, C., Fields, A.C., Sobrero, M. et al. Effect of Anti-TNF Agents on Postoperative Outcomes in Inflammatory Bowel Disease Patients: a Single Institution Experience. J Gastrointest Surg 20, 1636–1642 (2016). https://doi.org/10.1007/s11605-016-3194-z

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  • DOI: https://doi.org/10.1007/s11605-016-3194-z

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